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Hernández-Xumet JE, García-Hernández AM, Fernández-González JP, Marrero-González CM. Exploring levels of empathy and assertiveness in final year physiotherapy students during clinical placements. Sci Rep 2024; 14:13349. [PMID: 38858441 PMCID: PMC11164891 DOI: 10.1038/s41598-024-64148-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024] Open
Abstract
Empathy and assertiveness are two essential soft skills for any healthcare professional's competence and ethical development. It has been shown that empathy can be influenced throughout the training of a future healthcare professional, particularly during the clinical placement period. This research aims to assess fourth-year physiotherapy students' empathic and assertive development before and after clinical placement. A longitudinal observational study was conducted with fourth-year physiotherapy students during the academic year 2022/2023. A preliminary assessment of empathy and assertiveness levels was carried out before the start of the clinical placement and at the end of the placement using the Individual Reactivity Index to assess empathy and the Rathus Test to assess assertiveness. The results show a statistically significant difference (p ≤ 0.05) in both the empathy subscales of perspective-taking and empathic-concern between the pre- and postassessment, as well as an inverse correlation between the empathy subscale of personal distress and assertiveness. It is concluded that students show adequate results in empathy and assertiveness. However, there is some influence of clinical practice on the development of empathy, and future intervention studies need to be considered. Furthermore, students with higher levels of assertiveness have lower levels of personal distress, suggesting that assertiveness is closely related to empathy.
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Affiliation(s)
- Juan-Elicio Hernández-Xumet
- Movement and Health Research Group, Departamento de Medicina Física y Farmacología, Facultad de Ciencias de La Salud, Universidad de La Laguna (ULL), La Laguna, Spain.
- Hospital Universitario Nuestra Señora de Candelaria, Servicio Canario de La Salud, Santa Cruz de Tenerife, Spain.
| | | | - Jerónimo-Pedro Fernández-González
- Movement and Health Research Group, Departamento de Medicina Física y Farmacología, Facultad de Ciencias de La Salud, Universidad de La Laguna (ULL), La Laguna, Spain
- Gerencia de Atención Primaria de Tenerife, Servicio Canario de La Salud, Santa Cruz de Tenerife, Spain
| | - Cristo-Manuel Marrero-González
- Movement and Health Research Group, Departamento de Medicina Física y Farmacología, Facultad de Ciencias de La Salud, Universidad de La Laguna (ULL), La Laguna, Spain
- Departamento de Enfermería, Facultad de Ciencias de La Salud, Universidad de La Laguna (ULL), La Laguna, Spain
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Huang R, Zhou Z, Liu Y, Lin M, Gong M, Xian S, Yin H, Meng T, Wang X, Wang Y, Chen W, Zhang C, Du E, Liu X, Lin Q, Wu H, Huang Z, Zhang J, Zhang G, Ji S. Empathy in undergraduate medical students: a multi-center cross-sectional study in China. BMC Psychiatry 2024; 24:414. [PMID: 38834981 PMCID: PMC11151548 DOI: 10.1186/s12888-023-05350-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/06/2023] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Fostering empathy has been continuously emphasized in the global medical education. Empathy is crucial to enhance patient-physician relationships, and is associated with medical students' academic and clinical performance. However, empathy level of medical students in China and related influencing factors are not clear. METHODS This was a cross-sectional study among medical students in 11 universities. We used the Jefferson Scale of Empathy Student-version of Chinese version to measure empathy level of medical students. Factors associated with empathy were identified by the univariate and multivariate logistic regression analyses. Based on the variables identified above, the nomogram was established to predict high empathy probability of medical students. Receiver operating characteristic curve, calibration plot and decision curve analysis were used to evaluate the discrimination, calibration and educational utility of the model. RESULTS We received 10,901 samples, but a total of 10,576 samples could be used for further analysis (effective response rate of 97.02%). The mean empathy score of undergraduate medical students was 67.38 (standard deviation = 9.39). Six variables including gender, university category, only child or not, self-perception doctor-patient relationship in hospitals, interest of medicine, Kolb learning style showed statistical significance with empathy of medical students (P < 0.05). Then, the nomogram was established based on six variables. The validation suggested the nomogram model was well calibrated and had good utility in education, as well as area under the curve of model prediction was 0.65. CONCLUSIONS We identify factors influencing empathy of undergraduate medical students. Moreover, increasing manifest and hidden curriculums on cultivating empathy of medical students may be needed among medical universities or schools in China.
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Affiliation(s)
- Runzhi Huang
- Department of Burns, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China
| | - Zhitong Zhou
- Tongji University School of Medicine, Shanghai, 200092, China
| | - Yifan Liu
- Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Min Lin
- Mental Health Education and Consultation Center, Chongqing Medical University, 61 Daxuecheng Middle Road, Chongqing, 401331, China
| | - Meiqiong Gong
- Office of Educational Administration, Shanghai University, Shanghai, 200444, China
| | - Shuyuan Xian
- Tongji University School of Medicine, Shanghai, 200092, China
| | - Huabin Yin
- Department of Orthopedics, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, 100 Haining Road, Shanghai, China
| | - Tong Meng
- Department of Orthopedics, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, 100 Haining Road, Shanghai, China
| | - Xiaonan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Beijing, 100069, China
| | - Yue Wang
- Department of Health Statistics, School of Public Health, Air Force Medical University, No.169,Changle West Road, Xi'an, 710032, China
| | - Wenfang Chen
- Faculty of Medicine, Jinggangshan University, 28 Xueyuan Road, Ji'An, 343009, China
| | - Chongyou Zhang
- Basic Medical College, Harbin Medical University, 157 Baojian Road, Heilongjiang, 150081, Heilongjiang, China
| | - Erbin Du
- Frist Clinical Medical College, Mudanjiang Medical University, 66 Tongxiang Street, Mudanjiang, 157011, China
| | - Xin Liu
- Department of Rheumatology and Immunology, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Qing Lin
- Department of Human Anatomy, Laboratory of Clinical Applied Anatomy, School of Basic Medical Sciences, Fujian Medical University, 1 Xuefu North Road, Fuzhou, 350122, China
| | - Hongbin Wu
- National Centre for Health Professions Education Development, Peking University, Beijing, 100191, China
- Institute of Medical Education, Peking University, 5 YiHeYuan Road, Beijing, 100871, China
| | - Zongqiang Huang
- Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe East Road, Zhengzhou, 450052, China
| | - Jie Zhang
- Tongji University School of Medicine, Shanghai, 200092, China
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, 2699 Gaoke West Road, Shanghai, 201204, China
| | - Guoyang Zhang
- Maastricht University School of Health Professions Education, Maastricht, the Netherlands.
| | - Shizhao Ji
- Department of Burns, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China.
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Del Barrio LG, Rodríguez-Díez C, Gea A, Arbea L, Pereira J, Díez N. Impact of a longitudinal course on medical professionalism on the empathy of medical students. PATIENT EDUCATION AND COUNSELING 2024; 119:108042. [PMID: 37978022 DOI: 10.1016/j.pec.2023.108042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/08/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Medical education should enhance empathy. We examined, using self-assessment instruments and standardized patients (SPs), the impact on empathy, of a multi-year intervention (years 4-6 of medical training) that uses reflective learning approaches. METHODS 241 final-year medical students participated; 110 from the 2018 graduation class (non-intervention group) and 131 from the 2019 graduation class (intervention group). Participants completed two self-reported empathy questionnaires - the Jefferson Scale of Empathy-Students (JSE-S) and the Interpersonal Reactivity Index (IRI) - and a personality questionnaire, the NEO Five-Factor Inventory. Additionally, SPs in a simulated station assessed participants' empathy with two patient-reported instruments: the Consultation and Relational Empathy (CARE) scale and the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE). RESULTS Empathy scores were significantly higher in the intervention group compared to the non-intervention group when assessed by the SP (p < 0.001). No differences were found in self-reported questionnaires between the two groups. CONCLUSION A longitudinal, multi-year reflection-based intervention enhanced empathy amongst medical students as assessed by SPs, but not when assessed by student self-reported measures. PRACTICE IMPLICATIONS Multi-year reflective learning interventions during clinical training nurture empathy in medical students. Assessments completed by SPs or patients may enhance the evaluation of empathy.
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Affiliation(s)
- Loreto García Del Barrio
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain; Department of Medical Education, Universidad de Navarra, Pamplona, Spain
| | | | - Alfredo Gea
- Department of Medical Education, Universidad de Navarra, Pamplona, Spain; Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain
| | - Leire Arbea
- Department of Medical Education, Universidad de Navarra, Pamplona, Spain; Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - José Pereira
- Department of Medical Education, Universidad de Navarra, Pamplona, Spain; Department of Family Medicine, McMaster University, Canada
| | - Nieves Díez
- Department of Medical Education, Universidad de Navarra, Pamplona, Spain; Department of Pathology, Anatomy and Physiology, Universidad de Navarra, Pamplona, Spain.
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Harvey SDC, Stacey CL. Being kind in unkind spaces: a qualitative examination of how medical educators and first year medical students perceive empathy training. FRONTIERS IN SOCIOLOGY 2024; 8:1272357. [PMID: 38314067 PMCID: PMC10834759 DOI: 10.3389/fsoc.2023.1272357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/12/2023] [Indexed: 02/06/2024]
Abstract
Introduction It has become de rigueur for healthcare systems to tout their ability to provide compassionate medical care that addresses the emotional as well as physical needs of patients. Not surprisingly, then, there is considerable pressure on medical schools to train their students to be empathic. Existing literature on empathy training in medicine tends to focus on how to build emotional intelligence in individual trainees, largely ignoring the sociocultural factors that contribute to or thwart empathy development in medical school. Additionally, research tends to examine student perspectives, with little attention given to medical educators and their viewpoints. Methods In this paper, we adopt an "emotion practice" framework and utilize an inductive descriptive study design to qualitatively consider how first year medical students (N = 23) and their instructors (N = 9) perceive empathy training at a site we call Midtown Medical School. Results and discussion We find that both groups have an understanding of empathic capital but differ in their beliefs about the utility and legitimacy of this capital. Both educators and students also recognize the limitations of standardized empathy curriculum but do not agree on the implications of such rote learning. Finally, students and instructors alike find the hidden curriculum of medical school to be antithetical to empathy development, concurring that it is difficult to cultivate empathy in spaces where biomedical coursework is prioritized over social-emotional learning. In short, both groups find it difficult to be kind in an unkind place.
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Affiliation(s)
- Sarah D C Harvey
- Department of Sociology and Criminology, Kent State University, Kent, OH, United States
| | - Clare L Stacey
- Department of Sociology and Criminology, Kent State University, Kent, OH, United States
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Watari T, Houchens N, Otsuka T, Endo T, Odagawa S, Nakano Y, Kataoka H, Miwa M, Yamasaki D, Tokuda Y, Shiraishi Y, Sakaguchi K. Differences in empathy levels among physicians based on specialty: a nationwide cross-sectional study. Postgrad Med J 2023; 99:1258-1265. [PMID: 37742090 DOI: 10.1093/postmj/qgad084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/26/2023] [Accepted: 05/17/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE OF STUDY A physician's ability to empathize is crucial for patient health outcomes, and this differs according to speciality, personal characteristics, and environmental factors. This study aimed to examine the empathy levels among physicians based on their specialities and to identify the influencing factors. STUDY DESIGN A nationwide, online, cross-sectional survey was conducted using the Nikkei Business Publication online physician member homepage. Participants were 5441 physicians in Japan registered as members of Nikkei Medical Online across 20 specialities. We used the Jefferson Scale of Empathy (JSE) to measure the physicians' empathy levels. Cronbach's alpha was 0.84. RESULTS The mean JSE score was 100.05, SD = 15.75. Multivariate analyses showed that the highest JSE scores were for general medicine [+5.58, 95% confidence interval (CI) 2.60-8.56], general surgery (+3.63, 95% CI 0.97-6.28), psychiatry (+3.47, 95% CI 1.76-5.17), and paediatrics (+1.92, 95% CI 0.11-3.73). Factors associated with higher JSE scores were being female (+5.86, 95% CI 4.68-7.04), managers (+1.11, 95% CI 0.16-2.07), working in a small hospital (+2.19, 95% CI 0.23-4.15), and with children (+3.32, 95% CI 2.29-4.36). CONCLUSIONS A significant decrease in the empathy levels was found when the parent of the participant was also a medical provider. Being a general medicine physician or a female physician in a high position who has children was positively and significantly correlated with high empathy levels.
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Affiliation(s)
- Takashi Watari
- General Medicine Center, Shimane University Hospital, Izumo city, Shimane 693-8501, Japan
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, United States
- Department of Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, United States
| | - Nathan Houchens
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, United States
- Department of Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, United States
| | - Tomoe Otsuka
- Faculty of Medicine, Shimane University, Shimane 693-8501, Japan
| | - Takeshi Endo
- General Medicine Center, Shimane University Hospital, Izumo city, Shimane 693-8501, Japan
| | - Seiji Odagawa
- General Medicine Center, Shimane University Hospital, Izumo city, Shimane 693-8501, Japan
| | - Yasuhisa Nakano
- Faculty of Medicine, Shimane University, Shimane 693-8501, Japan
| | - Hitomi Kataoka
- Center for Medical Education and Internationalization, Kyoto University, Kyoto city, Kyoto 606-8501, Japan
| | - Mamoru Miwa
- Nikkei Medical Online, Nikkei Business Publications, Inc., Tokyo 105-8308, Japan
| | - Daisaku Yamasaki
- Nikkei Medical Online, Nikkei Business Publications, Inc., Tokyo 105-8308, Japan
| | - Yasuharu Tokuda
- Muribushi Okinawa Center for Teaching Hospitals, Okinawa 901-2132, Japan
| | - Yoshihiko Shiraishi
- General Medicine Center, Shimane University Hospital, Izumo city, Shimane 693-8501, Japan
| | - Kota Sakaguchi
- General Medicine Center, Shimane University Hospital, Izumo city, Shimane 693-8501, Japan
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Watari T, Houchens N, Nishizaki Y, Kataoka K, Otsuka T, Nakano Y, Sakaguchi K, Shiraishi Y, Katayama K, Kataoka H, Tokuda Y. Empathy competence and future specialty among medical residents in Japan: a nationwide cross-sectional study. Sci Rep 2023; 13:13742. [PMID: 37612358 PMCID: PMC10447498 DOI: 10.1038/s41598-023-41011-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/20/2023] [Indexed: 08/25/2023] Open
Abstract
Empathy is essential for physicians to provide patient-centered care. Nevertheless, the degree to which empathy varies among medical residents based on their desired future specialty remains undetermined. This nationwide cross-sectional study compared empathy levels (Jefferson Scale of Empathy, JSE) of 824 year one and two postgraduate residents in Japan by intended medical specialty, individual characteristics, and training and working environment characteristics. Empathy levels were compared with applicants for general medicine, which emphasizes patient-centeredness. The highest mean JSE and the highest percentage of women residents were observed in general medicine (M = 109.74; SD = 14.04), followed by dermatology (M = 106.64; SD = 16.90), obstetrics and gynecology (M = 106.48; SD = 14.31), and pediatrics (106.02; SD 12.18). Residents interested in procedure-centered departments (e.g. ophthalmology, orthopedics) garnered lower JSE scores. Multivariate regression revealed that future general medicine candidates achieved the highest JSE scores ([Formula: see text] = 6.68, 95% CI 2.39-10.9, p = 0.002). Women achieved significantly higher JSE scores than men ([Formula: see text] = 2.42, 95% CI 0.11-4.73, p = 0.041). The results have implications for empathy training and postgraduate education strategy in different clinical specialties.
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Affiliation(s)
- Takashi Watari
- General Medicine Center, Shimane University Hospital, Izumo, Shimane, Japan.
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
- Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
| | - Nathan Houchens
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Yuji Nishizaki
- Medical Technology Innovation Center, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - Koshi Kataoka
- Medical Technology Innovation Center, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - Tomoe Otsuka
- Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Yasuhisa Nakano
- Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Kota Sakaguchi
- General Medicine Center, Shimane University Hospital, Izumo, Shimane, Japan
| | | | - Kohta Katayama
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Hitomi Kataoka
- Diversity and Inclusion Center, Okayama University Hospital, Okayama, Japan
| | - Yasuharu Tokuda
- Muribushi Okinawa Project for Teaching Hospitals, Okinawa, Japan
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Nakazawa A, Iwamoto M, Kurazume R, Nunoi M, Kobayashi M, Honda M. Augmented reality-based affective training for improving care communication skill and empathy. PLoS One 2023; 18:e0288175. [PMID: 37428739 DOI: 10.1371/journal.pone.0288175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 06/21/2023] [Indexed: 07/12/2023] Open
Abstract
It is important for caregivers of people with dementia (PwD) to have good patient communication skills as it has been known to reduce the behavioral and psychological symptoms of dementia (BPSD) of PwD as well as caregiver burnout. However, acquiring such skills often requires one-on-one affective training, which can be costly. In this study, we propose affective training using augmented reality (AR) for supporting the acquisition of such skills. The system uses see-through AR glasses and a nursing training doll to train the user in both practical nursing skills and affective skills such as eye contact and patient communication. The experiment was conducted with 38 nursing students. The participants were assigned to either the Doll group, which only used a doll for training, or the AR group, which used both a doll and the AR system. The results showed that eye contact significantly increased and the face-to-face distance and angle decreased in the AR group, while the Doll group had no significant difference. In addition, the empathy score of the AR group significantly increased after the training. Upon analyzing the correlation between personality and changes of physical skills, we found a significant positive correlation between the improvement rate of eye contact and extraversion in the AR group. These results demonstrated that affective training using AR is effective for improving caregivers' physical skills and their empathy for their patients. We believe that this system will be beneficial not only for dementia caregivers but for anyone looking to improve their general communication skills.
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Affiliation(s)
- Atsushi Nakazawa
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Miyuki Iwamoto
- Department of Advanced Fibro-Science, Kyoto Institute of Technology, Kyoto, Japan
| | - Ryo Kurazume
- Faculty of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
| | - Masato Nunoi
- School of Human Sciences, Sugiyama Jogakuen University, Nagoya, Aichi, Japan
| | - Masaki Kobayashi
- Division of geriatric medicine, Rochester Regional Health System, Rochester, NY, United States of America
| | - Miwako Honda
- Division of Geriatric Research, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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Hurissa BF, Koricha ZB, Dadi LS. Effect of empathy training on the empathy level of healthcare providers in Ethiopia: a cluster randomized controlled trial. Front Psychol 2023; 14:1091605. [PMID: 37284470 PMCID: PMC10239930 DOI: 10.3389/fpsyg.2023.1091605] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/21/2023] [Indexed: 06/08/2023] Open
Abstract
Objective Empathy has deteriorated throughout clinical training and medical practice, and little is known about the effect of empathy training on the empathy level of healthcare providers. To address this gap, we assessed the effect of empathy training on the empathy level of healthcare providers in Ethiopia. Design A cluster randomized controlled trial study design was conducted from 20 December 2021 to 20 March 2022. The empathy training intervention was conducted for three consecutive days. Setting The study was conducted in five fistula treatment centers in Ethiopia. Participants The participants were all randomly selected healthcare providers. Main outcome measures Total mean score, percentage changes, and Cohen's effect size were computed. A linear mixed effects model and independent t-test were used for data analysis. Results A majority of the study participants were nurses in the profession, married, and first-degree holders. There was no statistically significant difference in the baseline empathy score of the intervention arm across their socio-demographic features. At the baseline, the mean empathy scores of the control and intervention arms were 102.10 ± 15.38 and 101.13 ± 17.67, respectively. The effect of empathy training on the total mean score changes of empathy of the intervention arm compared to the control arm at each follow-up time had a statistically significant difference. After a week, a month, and three months of post-intervention, the total mean empathy scores between the intervention and control arms were as follows: (intervention 112.65 ± 18.99, control 102.85 ± 15.65, d = 0.55, p = 0.03); (intervention 109.01 ± 17.79, control 100.52 ± 12.57, d = 0.53, p = 0.034); and (intervention 106.28 ± 16.24, control 96.58 ± 14.69, d = 0.60, p = 0.016) with the overall percentage changes of 11, 8, and 5% from the baseline scores, respectively. Conclusion In this trial, the empathy training intervention was found to have more than a medium effect size. However, over the follow-up intervals, there was a decreasing trend in the total mean empathy scores of healthcare providers; suggesting that there should be continued empathy training and integration of it into educational and training curriculums to enhance and sustain the empathy of healthcare providers.Clinical Trial Registration: Pan African Clinical Trial Registry: http://www.edctp.org/panafrican-clinical-trials-registry or https://pactr.samrc.ac.za, PACTR202112564898934.
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Affiliation(s)
| | - Zewdie Birhanu Koricha
- Department of Health, Behavior, and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Lelisa Sena Dadi
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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9
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A stenography of empathy: Toward a consensual model of the empathic process. L'ENCEPHALE 2023:S0013-7006(23)00012-X. [PMID: 36775761 DOI: 10.1016/j.encep.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 02/12/2023]
Abstract
Empathy has gained popularity in the general population and the scientific world during the past decade. Recently, several researchers found a significant decrease in empathy scores of healthcare students (notably medical students) and recommend promoting empathy skills in several fields of education. The current paper presents a new model of the empathic process: a stenography of empathy compelling scientific data and contemporary conceptions. Indeed, we combined all pioneer researchers' conceptions of empathy (Davis, Decety, Batson, Preston & de Waal) into an integrative model. This model is centered on the empathizer (i.e., a person observing a target experiencing emotions) and displays how all empathy components are articulated, explaining the individuals' general functioning and how the process might become dysfunctional. We illustrated applications of the model with three clinical examples (i.e., burnout, psychopathy, and borderline personality disorders) to display how empathy is related to psychopathological symptoms. We believe this new dynamic and sequential model would be helpful in explaining how empathy works, which is of great interest to healthcare students, clinicians, researchers, and academics.
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Kagawa Y, Ishikawa H, Son D, Okuhara T, Okada H, Ueno H, Goto E, Tsunezumi A, Kiuchi T. Using patient storytelling to improve medical students' empathy in Japan: a pre-post study. BMC MEDICAL EDUCATION 2023; 23:67. [PMID: 36707818 PMCID: PMC9881337 DOI: 10.1186/s12909-023-04054-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Empathy for patients is now internationally accepted as one of the competencies of physicians for patient-centered medical practice and an essential component of medical education. Recently, "patient storytelling" has attracted attention in empathy education for medical students to understand patients' experiences, feelings, and perspectives. This study aimed to quantitatively evaluate how patient storytelling enhanced undergraduate medical students' empathy in Japan to the extent that they sustained it for six months. METHODS Participants were 159 fourth-year undergraduate medical students in Tokyo in academic years 2018 and 2019. The questionnaire surveys were conducted three times: at the beginning of the class, immediately after the class, and six months after the class. The Japanese version of the Jefferson Scale of Empathy-Student Version was used in this study. Gender, age, and clinical orientation were also obtained through the self-reported questionnaire. We invited a male patient storyteller who was diagnosed with chronic kidney disease to the classes on "Professionalism." The title of his storytelling was "The Power of Medical Professionals' Words." RESULTS JSE-S scores improved significantly immediately after listening to patient storytelling. The scores remained improved six months after the class. Interest of specialty was significantly positively associated with an immediate change in JSE-S scores. However, gender had no significant association with changes in JSE-S scores either immediately or six months after education. CONCLUSIONS Our findings may suggest that patient storytelling would be useful to cultivate empathy among undergraduate medical students. It is to be expected that more medical schools will use patient storytelling to educate medical students in humanistic and communication education.
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Affiliation(s)
- Yumi Kagawa
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | | | - Daisuke Son
- Department of Community-based Family Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Haruka Ueno
- Department of Health and Dietetics, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan
| | - Eiko Goto
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Aiko Tsunezumi
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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11
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Yuen JK, See C, Cheung JTK, Lum CM, Lee JS, Wong WT. Can teaching serious illness communication skills foster multidimensional empathy? A mixed-methods study. BMC MEDICAL EDUCATION 2023; 23:20. [PMID: 36631787 PMCID: PMC9835381 DOI: 10.1186/s12909-023-04010-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND To investigate the impact of a serious illness communication skills training course on medical students' attitudes regarding clinical empathy, self-efficacy in empathic communication, and learning on different dimensions of empathy. METHODS A mixed-methods design was used. A blended learning Serious Illness Communication Skills Training (SI-CST) course was delivered to sixth-year medical students. Students (n=185) completed questionnaires with the 20-item Jefferson Scale of Empathy (JSE) and self-rated preparedness level for five empathic communication tasks at baseline (T1), six weeks (T2), and three-to-six months post-training (T3). Written reflections on key lessons learned were analyzed using inductive thematic analysis. RESULTS Total JSE scores significantly improved from T1 to T2 (111.4 vs 113.9, P=.01) and from T1 to T3 (111.4 vs 113.9, P=.01). There was an increase in Standing in Patient's Shoes subscale of the JSE with an effect size of 0.56 whereas the Perspective-Taking and Compassionate Care subscales showed no significant changes. Self-rated preparedness for all five empathic communication tasks significantly improved from T1 to T2 (P ≤ .001) and from T1 to T3 (P ≤ .001) with large effect sizes (1.09-1.41). Four key themes emerged from the qualitative analysis. They were appreciating the important role of empathy in clinical care (moral empathy), learning skills in detecting and understanding patient emotions (cognitive empathy), learning skills in responding to emotion with empathy (behavioral empathy), and appreciating that communication skills can be improved with continual practice and self-reflection. CONCLUSIONS Our results revealed that SI-CST improved medical students' empathic attitudes and self-efficacy in empathic communication. Qualitative results found learning on the cognitive, behavioral and moral dimensions of empathy.
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Affiliation(s)
- Jacqueline K Yuen
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, 4/F Professorial Block, 102 Pokfulam Road, Pokfulam, Hong Kong SAR, China.
| | - Christopher See
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Johnny T K Cheung
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chor Ming Lum
- Department of Medical and Geriatrics, Shatin Hospital, Hong Kong SAR, China
| | - Jenny Sw Lee
- Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, China
| | - Wai Tat Wong
- Department of Anaesthesia & Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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12
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Samarasekera DD, Lee SS, Yeo JHT, Yeo SP, Ponnamperuma G. Empathy in health professions education: What works, gaps and areas for improvement. MEDICAL EDUCATION 2023; 57:86-101. [PMID: 35790499 DOI: 10.1111/medu.14865] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/05/2022] [Accepted: 06/26/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Developing a physician equipped with both technical and affective skills is crucial in ensuring quality patient care. Of these skills, nurturing empathy is a key skill that has been studied in great detail, particularly among medical undergraduates. Despite numerous studies trending the changes in empathy, the results are often contradictory or confusing. Our study aims to find what interventions are effective to inculcate empathy in both undergraduate and postgraduate medical education and suggest areas for improvement. METHODS A narrative review was conducted on the interventions in nurturing empathy in undergraduate and postgraduate medical education. Original research articles and systematic reviews with clear interventions and outcomes were included in the study. RESULTS A total of 44 articles were reviewed. About 44% (n = 18) of the studies used a mixture of different approaches as their interventions. Some interventions were anchored by specific topics: Seven papers focusing on communication skills, three papers on humanities, and three on arts. A majority of the interventions (60%; n = 26) were implemented over a span of time as compared to studies which suggested a one-off intervention (30%; n = 12). Of the 26 papers in which the interventions were enforced over a period of time, 62% (n = 16) indicated an increase in student empathy whereas 16% (n = 4) indicated no changes in empathy post-intervention. On the contrary, 50% (n = 6) of the one-off interventions revealed no significant change in student empathy. Jefferson Scale of Empathy (JSE) is widely used in measuring student empathy postintervention, but approximately 41% of the studies included measuring tools other than JSE. CONCLUSIONS Pedagogical methods that invoke thought processes related to the affective domain of learning and experiential learning are more effective than the didactic methods of teaching and learning. Multimodal mixed-methods approach that combine different pedagogical interventions is more likely to bring about the desired results.
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Affiliation(s)
- Dujeepa D Samarasekera
- Centre for Medical Education (CenMED), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shuh Shing Lee
- Centre for Medical Education (CenMED), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jillian H T Yeo
- Centre for Medical Education (CenMED), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Su Ping Yeo
- Centre for Medical Education (CenMED), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gominda Ponnamperuma
- Department of Medical Education, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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13
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The negative impact of xenophobia on compassion with suffering out-group members is attenuated by trait empathy. Sci Rep 2022; 12:18951. [PMID: 36347950 PMCID: PMC9643350 DOI: 10.1038/s41598-022-23776-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022] Open
Abstract
Empathy enables human beings to understand and share the internal states of others. Studies show that empathy for pain is higher for in-group compared to out-group members. This might be driven by attitudes and biases towards out-groups. In a between subject design, N = 621 participants filled in questionnaires measuring xenophobia and trait empathy and were presented with photos of suffering individuals either from the in-group or an out-group, which had to be rated with respect to negative affect and the willingness to help the depicted persons. Results do not show more compassion with members of the in-group in general, but a negative effect of xenophobia on state empathy in the out-group condition. Additional moderation analyses show that this effect is less evident in presence of high trait empathy scores. Our results highlight the importance of empathy trainings to attenuate the effects of xenophobic attitudes on social cohabitation in our increasingly polarized and culturally diverse societies.
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14
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Venktaramana V, Loh EKY, Wong CJW, Yeo JW, Teo AYT, Chiam CSY, Foo DJM, Teo F, Liang J, Raveendran V, Chng LCL, Xiao S, Chong K, Quek SL, Chiang CLL, Toh RQE, Ng CWH, Lim EG, Leong S, Tay KT, Chan A, Chia EWY, Tan LHS, Ong YT, Sheri K, Ng JX, Chin AMC, Zhou JX, Chiam M, Lee ASI, Mason S, Krishna LKR. A systematic scoping review of communication skills training in medical schools between 2000 and 2020. MEDICAL TEACHER 2022; 44:997-1006. [PMID: 35653622 DOI: 10.1080/0142159x.2022.2054693] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Communication skills training (CST) remains poorly represented and prioritised in medical schools despite its importance. A systematic scoping review (SSR) of CST is proposed to better appreciate current variability in their structure, content, and assessment. This is to guide their future design in medical school curricula. METHODS The Systematic Evidence-Based Approach (SEBA) was used to guide concurrent SSRs of teaching and assessment in CST. After independent database searches, concurrent thematic and content analysis of included articles were conducted separately. Resultant themes/categories were combined via the jigsaw perspective to provide a more holistic view of the data. These were then compared to tabulated summaries of the included articles to create funnelled domains. RESULTS 52,300 papers were identified, 150 full-text articles included, and four funnelled domains were identified: Indications, Design, Assessment, and Barriers and Enablers of CST. CSTs confer numerous benefits to physicians and patients. It saw increased confidence, improved diagnostic capabilities and better clinical management, as well as greater patient satisfaction and treatment compliance. Skills may be divided into core, prerequisite competencies, and advanced skills pertinent to more challenging and nuanced scenarios - such as population or setting-specific situations. CST teaching and assessment modalities were found to align with Miller's Pyramid, with didactic teaching gradually infused with experiential approaches to enhance their understanding and integration. A plethora of CST frameworks, teaching and assessment methods were identified and are presented together. CONCLUSION While variable in approach, content and assessment, CST in medical schools often employ stage-based curricula to instil competency-based topics of increasing complexity throughout medical school education. This process builds on the application of prior knowledge and skills, influencing practice and, potentially, the students' professional identity formation. In addition, the institution plays a critical role in overseeing training, ensuring longitudinal guidance and holistic assessments of the students' progress.
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Affiliation(s)
- Vaishnavi Venktaramana
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Eleanor Kei Ying Loh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Clarissa Jing Wen Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Jun Wei Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Andrea York Tiang Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Celest Sin Yu Chiam
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Dillon Jie Ming Foo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Faith Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Jonathan Liang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Vijayprasanth Raveendran
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Luke Cheng Lin Chng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Shiwei Xiao
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Kevin Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Seng Leong Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Christine Li Ling Chiang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Rachelle Qi En Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Caleb Wei Hao Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Elijah Gin Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Shariel Leong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Kuang Teck Tay
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Amos Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Elisha Wan Ying Chia
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Laura Hui Shuen Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Krish Sheri
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Jun Xuan Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Annelissa Mien Chew Chin
- Medical Library, National University of Singapore Libraries, National University of Singapore, Singapore, Singapore
| | - Jamie Xuelian Zhou
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Alexia Sze Inn Lee
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Stephen Mason
- Palliative Care Unit Liverpool, University of Liverpool, Liverpool, UK
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Palliative Care Unit Liverpool, University of Liverpool, Liverpool, UK
- Centre of Biomedical Ethics, National University of Singapore, Singapore, Singapore
- PalC, The Palliative Care Centre for Excellence in Research and Education Singapore, Dover Park Hospice, Singapore, Singapore
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Voultsos P, Chatzinikolaou F, Papana A, Deliligka A. Reliability of Greek version of the Toronto empathy questionnaire in medical students and associations with sociodemographic and lifestyle factors. BMC Psychol 2022; 10:113. [PMID: 35501889 PMCID: PMC9063083 DOI: 10.1186/s40359-022-00824-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/26/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Empathy is an important key driver of any therapeutic relationship. It is beneficial for both physicians and patients. Enhancing physician's empathy should be an important goal of medical education. As there was a literature gap regarding the topic of empathy among medical students in Greece, this study aimed to contribute to filling this gap. METHODS A cross-sectional study was conducted. A socio-demographic questionnaire and the 52-item Greek version of the Toronto composite empathy scale (TCES) for measuring the cognitive and emotional aspects of empathy in both personal and professional life was administered to all the medical students in the Aristotle University of Thessaloniki, in Greece. Descriptive statistics were displayed for demographics. The associations of the variables were quantified by Chi-2 independence tests and Pearson's Correlation Coefficient. The reliability and validity of the questionnaire was determined by Cronbach's α, Hotelling's T-Squared Test, and Pearson correlation. Paired and Independent Sample T-Tests and One-way ANOVAs indicated statistically significant mean differences among the variables or subgroups of the variables. RESULTS The 52-item TCES, 26 for the personal (Per) setting and another 26 for professional (Pro) life, equally divided into cognitive (Cog) and emotional (Emo) empathy in each case. The overall reliability of the TCES questionnaire was found to be high (Cronbach's α = 0.895, significant positive correlations between the subscales). The mean total score of empathy showed that students had a moderately high empathy. Further, there was a statistically significant difference in means between the Per-Cog and Per-Emo settings (p < 0.001), the Pro-Cog and Pro-Emo (p < 0.001), the Per-Cog and Pro-Cog (p = 0.004), and the Per-Emo and Pro-Emo (p < 0.001). Females had significantly higher empathy scores (mean score 208.04) than males (192.5) on the Per-Cog, Per-Emo and Pro-Emo subscales. Furthermore, a positive correlation was found between empathy and factors such as love for animals, interest in medical ethics, belief in God, having an ill person in the family, class year or carrier intention. CONCLUSIONS The TCES is applicable to medical students. For the most part our findings were consistent with previous literature. However, we identified some nuances that might draw researchers' attention. The results of this study may contribute to plan interventions in the curriculum to enhance empathy in the medical students.
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Affiliation(s)
- Polychronis Voultsos
- Laboratory of Forensic Medicine and Toxicology (Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, 541 24, Thessaloniki, Greece.
| | - Fotios Chatzinikolaou
- Laboratory of Forensic Medicine and Toxicology (Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, 541 24, Thessaloniki, Greece
| | - Angeliki Papana
- Department of Economics, School of Economics and Regional Studies, University of Macedonia, Egnatia Str 156, 546 36, Thessaloniki, Greece
| | - Aspasia Deliligka
- AHEPA University Hospital, Kiriakidi Str 1, 546 21, Thessaloniki, Greece
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16
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Yu CC, Tan L, LE MK, Tang B, Liaw SY, Tierney T, Ho YY, Lim BEE, Lim D, Ng R, Chia SC, Low JA. The development of empathy in the healthcare setting: a qualitative approach. BMC MEDICAL EDUCATION 2022; 22:245. [PMID: 35379249 PMCID: PMC8981670 DOI: 10.1186/s12909-022-03312-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/24/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND Healthcare professionals' empathetic behaviors have been known to lead to higher satisfaction levels and produce better health outcomes for patients. However, empathy could decrease over time especially during training and clinical practice. This study explored factors that contributed to the development of empathy in the healthcare setting. Findings could be used to improve the effectiveness and sustainability of empathy training. METHOD A qualitative approach, informed by aspects of grounded theory, was utilized to identify factors that enabled the development of empathy from the perspectives of doctors, nurses, allied healthcare workers and students. Twelve sessions of focus group discussions were conducted with 60 participants from two hospitals, a medical school, and a nursing school. Data was analyzed independently by three investigators who later corroborated to refine the codes, subthemes, and themes. Factors which influence the development of empathy were identified and categorized. This formed the basis of the creation of a tentative theory of empathy development for the healthcare setting. RESULTS The authors identified various personal (e.g. inherent characteristics, physiological and mental states, professional identity) and external (e.g. work environment, life experience, situational stressors) factors that affected the development of empathy. These could be further categorized into three groups based on the stability of their impact on the individuals' empathy state, contributed by high, medium, or low stability factors. Findings suggest empathy is more trait-like and stable in nature but is also susceptible to fluctuation depending on the circumstances faced by healthcare professionals. Interventions targeting medium and low stability factors could potentially promote the development of empathy in the clinical setting. CONCLUSIONS Understanding factors that impact the development of empathy allows us to develop measures that could be implemented during training or at the workplace leading to improve the quality of care and higher clinical work satisfaction.
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Affiliation(s)
- Chou Chuen Yu
- Geriatric Education and Research Institute Ltd, Singapore, Singapore
| | - Laurence Tan
- Geriatric Education and Research Institute Ltd, Singapore, Singapore
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Mai Khanh LE
- Geriatric Education and Research Institute Ltd, Singapore, Singapore
| | - Bernard Tang
- Geriatric Education and Research Institute Ltd, Singapore, Singapore.
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tanya Tierney
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Yun Ying Ho
- Ministry of Health Holdings, Singapore, Singapore
| | - Beng Eng Evelyn Lim
- School of Health & Social Sciences, Nanyang Polytechnic, Singapore, Singapore
| | - Daphne Lim
- School of Health & Social Sciences, Nanyang Polytechnic, Singapore, Singapore
| | - Reuben Ng
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
| | | | - James Alvin Low
- Geriatric Education and Research Institute Ltd, Singapore, Singapore
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
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17
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Paulus CM, Meinken S. The effectiveness of empathy training in health care: a meta-analysis of training content and methods. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2022; 13:1-9. [PMID: 35092671 PMCID: PMC8995011 DOI: 10.5116/ijme.61d4.4216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/04/2022] [Indexed: 06/01/2023]
Abstract
OBJECTIVES The meta-analysis examined the question of whether empathy training is effective in health care and whether specific training content and methods can be found to account for its effectiveness. METHODS We included 13 out of 50 studies (total N = 1315) that fulfilled the search criteria. R version 4.0.5 with the esc, meta, metafor, and dmetar packages and SPSS28 were used to conduct the meta-analysis based on the random-effects model. The effect sizes were calculated using Hedge`s g, and heterogeneity was tested using Cochran's Q. In addition, the multicollinearity of the moderators was checked. RESULTS The overall effect size (Hedge´s g = 0.58, s = 0.10, p = 0.00) indicated a moderate effect of empathy training. There was a significant heterogeneity (I2 = 76.9%, Q = 84.82, p=0.00), thus we examined whether individual training methods have influenced effect sizes, which could not be confirmed (F (8,4) = 0.98, p = 0.55). The same applied to the training contents (F (6,6) = 0.27, p = 0.93). CONCLUSIONS The present study showed that empathy training could be effective. This confirmed previous findings and supported the use of such training. However, according to our results, no significant moderators could be found, i.e., the training contents or methods did not contribute to the effect sizes. For meaningful findings, a comparison of different training components should definitely be made, and it should be investigated whether empathy training spread over a period of time is more effective and sustainable than one-time training.
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Affiliation(s)
- Christoph M. Paulus
- Faculty of Empirical Human Sciences and Economics, Saarland University, Germany
| | - Saskia Meinken
- Faculty of Empirical Human Sciences and Economics, Saarland University, Germany
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18
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Lermen C, Wetzel W, Britz V, Sterz J, Bechstein WO, Schreckenbach T. Empathy, personality traits, and emotional management in 2nd and 4th-year dentistry students: a single-center study. BMC MEDICAL EDUCATION 2022; 22:2. [PMID: 34980112 PMCID: PMC8722276 DOI: 10.1186/s12909-021-03080-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Patients fearing dental interventions are at risk of delaying or skipping much-needed treatments. Empathic communication could lead to a higher rate of compliance from patients within this group. Empathy, the big five personality traits, and emotion management abilities are all known to influence the quality of communication between dentists and patients. This study was conducted to analyze whether there is a correlation between these factors in dentistry students. METHODS Dentistry students in their 2nd and 4th year of study were asked to complete questionnaires assessing empathy, emotion management, and personality traits. Out of a total of 148 eligible participants, 53 students (34%) volunteered to participate. For empathy, the Jefferson Scale of Physician Empathy (students' version; JSPE-S) and the Interpersonal Reactivity Index (IRI) were used. Personality traits were assessed using the Short Big Five Inventory (BFI-s), and the Situational Test of Emotional Management (STEM) to measure emotional management ability. RESULTS Higher scores for emotion management were significantly correlated with the female gender (p ≤ 0.005) and with higher scores in openness (p ≤ 0.05). Students with higher scores in openness also achieved higher scores on the IRI subscales: Perspective taking (p ≤ 0.05), Fantasy (p ≤ 0.01), Empathic concern (p ≤ 0.05), and Personal distress (p ≤ 0.05). For JSPE-S, no correlation with emotion management and personality traits was found. CONCLUSION Empathy and emotion management might not be significantly related in dentistry students. Regarding personality traits, students who scored higher on openness also indicated higher abilities in emotion management. These findings should be taken into consideration when planning communication courses for dentistry students, as it might be possible to independently train empathy and emotion management as part of emotional intelligence.
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Affiliation(s)
- Christian Lermen
- Goethe-University Frankfurt/Main, Department of General, Visceral, Transplantation and Thoracic Surgery, Goethe-University Frankfurt am Main, Frankfurt University Hospital and Clinics, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
| | - Willi Wetzel
- Department of Oral Surgery and Implantology, Goethe-University Frankfurt am Main, Carolinum, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
| | - Vanessa Britz
- Goethe-University Frankfurt am Main, Frankfurt interdisciplinary simulation center FIneST, Medical Faculty, Goethe University, Frankfurt, Germany
| | - Jasmina Sterz
- Goethe-University Frankfurt am Main, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe-University Frankfurt am Main, Frankfurt/Main, Germany
| | - Wolf O Bechstein
- Goethe-University Frankfurt/Main, Department of General, Visceral, Transplantation and Thoracic Surgery, Goethe-University Frankfurt am Main, Frankfurt University Hospital and Clinics, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
| | - Teresa Schreckenbach
- Goethe-University Frankfurt/Main, Department of General, Visceral, Transplantation and Thoracic Surgery, Goethe-University Frankfurt am Main, Frankfurt University Hospital and Clinics, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany.
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19
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Potts LC, Bakolis I, Deb T, Lempp H, Vince T, Benbow Y, Waugh W, Kim S, Raza S, Henderson C. Anti-stigma training and positive changes in mental illness stigma outcomes in medical students in ten countries: a mediation analysis on pathways via empathy development and anxiety reduction. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1861-1873. [PMID: 35451604 PMCID: PMC9375761 DOI: 10.1007/s00127-022-02284-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/31/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE Studies of mental illness stigma reduction interventions have been criticised for failing to evaluate behavioural outcomes and mechanisms of action. This project evaluates training for medical students entitled 'Responding to Experienced and Anticipated Discrimination' (READ), developed to focus on skills in addition to attitudes and knowledge. We aimed to (i) evaluate the effectiveness of READ with respect to knowledge, attitudes, and clinical communication skills in responding to mental illness-related discrimination, and (ii) investigate whether its potential effectiveness was mediated via empathy or/and intergroup anxiety. METHODS This is an international multisite non-randomised pre- vs post-controlled study. Eligible medical students were currently undertaking their rotational training in psychiatry. Thirteen sites across ten countries (n = 570) were included in the final analysis. RESULTS READ was associated with positive changes in knowledge (mean difference 1.35; 95% CI 0.87 to 1.82), attitudes (mean difference - 2.50; 95% CI - 3.54 to - 1.46), skills (odds ratio 2.98; 95% CI 1.90 to 4.67), and simulated patient perceived empathy (mean difference 3.05; 95% CI 1.90 to 4.21). The associations of READ with knowledge, attitudes, and communication skills but not with simulated patient perceived empathy were partly mediated through student reported empathy and intergroup anxiety. CONCLUSION This is the first study to identify mediating effects of reduced intergroup anxiety and increased empathy in an evaluation of anti-stigma training that includes behavioural measures in the form of communication skills and perceived empathy. It shows the importance of both mediators for all of knowledge, skills, and attitudes, and hence of targeting both in future interventions.
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Affiliation(s)
- Laura C. Potts
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK
| | - Ioannis Bakolis
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK ,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Tanya Deb
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Heidi Lempp
- Centre for Rheumatic Diseases, King’s College London, London, UK
| | - Tushar Vince
- GKT School of Medical Education, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Yasmin Benbow
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - William Waugh
- GKT School of Medical Education, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - San Kim
- GKT School of Medical Education, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Syed Raza
- GKT School of Medical Education, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Claire Henderson
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Öztürk A, Kaçan H. Compassionate communication levels of nursing students: Predictive role of empathic skills and nursing communication course. Perspect Psychiatr Care 2022; 58:248-255. [PMID: 34601733 DOI: 10.1111/ppc.12954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 09/19/2021] [Accepted: 09/26/2021] [Indexed: 12/30/2022] Open
Abstract
PURPOSE This study aims to determine the compassionate communication levels of nursing students and the predictive roles of empathic skills and nursing communication courses. DESIGN AND METHODS This descriptive study was conducted with 430 nursing students and data were analyzed using a descriptive information form, Compassionate Communication Scale (CCS), and Empathic Skill Scale (ESS). FINDINGS A positive relationship was found between the students' ESS and CCS scores (r = .23 p = 0.001). Empathic skills (β = 0.43, p = 0.001), predicted compassionate communication (β = 0.23, p = 0.001), compassionate conversation (β = 0.43, p = 0.001), and compassionate touch (β = 0.18, p = 0.001). PRACTICE IMPLICATIONS Skills of compassion and empathy positively affect each other; therefore, it is important to adopt strategies that strengthen the empathic skills of nursing students during academic education and to include empathy and compassion in the curriculum.
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Affiliation(s)
- Ayfer Öztürk
- Psychiatry Nursing Department, Faculty of Health Sciences, Bartın University, Bartın, Turkey
| | - Havva Kaçan
- Psychiatry Nursing Department, Faculty of Health Sciences, Kastamonu University, Kastamonu, Turkey
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Liew SC, Fadil Azim DH. In someone else's shoes, are all wearers the same? Empathy in multi-ethnic Asian medical students. J Taibah Univ Med Sci 2021; 17:498-505. [PMID: 35722235 PMCID: PMC9170763 DOI: 10.1016/j.jtumed.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/28/2021] [Accepted: 11/10/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives Considerable research interest has been observed in ascertaining the actual pattern of empathy skill acquisition, but this aspect remains largely unexplored in Asian medical students. This study explored the empathy trait in Asian medical students from different levels of seniority and investigated the association between students’ empathy traits and their socio-demographic and socio-economic backgrounds. Methods To explore the empathy trait, the Year 1 to Year 5 medical students completed the students’ socio-demographic/economic and validated Interpersonal Reactivity Index (IRI) questionnaires. Results The participants scored highest in the empathetic concerns (EC) and lowest in the personal distress (PD) subscale. Female participants scored significantly higher on the EC, PD, and fantasy subscales. Participants who went to government high schools scored higher on the PD and EC subscales. Participants who stated a preference for specialisation that required more communication with patients scored higher on the EC and Perspective Taking subscales. Conclusions The empathy traits of Asian medical students may have cultural influences that are determined by their geographical background. Consistent observations regarding the inclination toward cognitive empathy traits in females were observed. This study also found that empathy traits are predictive of choices for postgraduate speciality training and that there is a difference in medical students’ empathy traits during the different phases of study in medical school.
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22
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Menezes P, Guraya SY, Guraya SS. A Systematic Review of Educational Interventions and Their Impact on Empathy and Compassion of Undergraduate Medical Students. Front Med (Lausanne) 2021; 8:758377. [PMID: 34820397 PMCID: PMC8606887 DOI: 10.3389/fmed.2021.758377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/14/2021] [Indexed: 12/30/2022] Open
Abstract
Introduction: A compassionate and patient-centered care leads to improved clinical outcomes. Promoting empathy and compassion of medical students is a forerunner of their well-being, emotional stability, and a patient-centered care. However, there is slender evidence about best educational interventions that can inculcate empathy and compassion skills. Our objective was to conduct a systematic review of research evaluating the associations between spectrum, effectiveness, frequency of teaching modalities and their outcomes on compassion and empathy to highlight best practices. Methods: We searched the Web of Science, PubMed, Scopus, and EBSCO Host on 22nd July 2020. We adapted our search strategy from a previously published systematic review on education for compassion and empathy. Selected studies were required to have used unique educational interventions for promoting empathy and compassion of medical students. The research questions were based on Participants (medical students), Intervention (empathy and/or compassion related teaching), Comparison, and Outcome. Results: We analyzed 24 articles from the initial yield of 2,861. Twenty-two were quantitative studies with a mean of 12.8 on MERSQI. Twelve were randomized controlled trials while 5 measured outcomes with single group pre- and post-tests. There was no association found between duration, frequency and complexity of an educational intervention and its effectiveness. Twenty used multimodality curricula, and of those 18 reported statistically significant positive improvement in empathy, while 3 of 4 single modality were effective. Only three studies looked for long-term effects of educational interventions. Fourteen studies evaluated Kirkpatrick's level one (self-reported knowledge), 2 level three (behavior), and 6 level four (patient outcomes). We identified six major educational constructs of teaching empathy and compassion; communication, mindfulness, early clinical exposure, technology-enhanced learning, comics and arts and culture. Discussion: Our review couldn't identify a standard teaching construct in place and highlighted that different teaching tools carry similar impact in promoting compassion and empathy and a sustainable program rather than a single training activity is essential.
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Affiliation(s)
- Prianna Menezes
- Royal College of Surgeons Ireland, Bahrain RCSI-Medical University of Bahrain (MUB), Busaiteen, Bahrain
| | | | - Shaista Salman Guraya
- Royal College of Surgeons Ireland, Bahrain RCSI-Medical University of Bahrain (MUB), Busaiteen, Bahrain
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Sharp A, Brown B, Shreve T, Moore K, Carlson M, Braughton D. Direct-Care Staff Perceptions of Patient Engagement and Treatment Planning in Detox. J Behav Health Serv Res 2021; 48:566-582. [PMID: 34590236 DOI: 10.1007/s11414-021-09757-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 11/24/2022]
Abstract
As the prevalence of substance use disorders and drug-related deaths continue to rise, addiction treatment facilities are charged with providing effective and efficient services to curb the national substance use crisis. Direct-care staff in treatment service facilities play a crucial role in whether or not evidence-based practices are incorporated. Without their understanding and utilization of patient engagement best practices, an organization risks maintaining the status quo rather than actively pursuing improved outcomes through empirically supported approaches. Through in-depth interviews (N=13) with nurses, counselors, and behavioral health technicians in an inpatient detoxification facility, this study evaluates the perspectives and experiences of direct-care staff through a lens of patient engagement in treatment planning. The findings from these interviews elucidate how participants' personal characteristics and values, perspectives of patient engagement, understanding of treatment planning, and organizational culture and operations facilitate or inhibit the integration of patient engagement for treatment planning in detox.
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Affiliation(s)
- Amanda Sharp
- Department of Mental Health Law & Policy, University of South Florida, 13301 Bruce B. Down Blvd., Tampa, FL, 33612, USA.
| | - Bonnie Brown
- Department of Mental Health Law & Policy, University of South Florida, 13301 Bruce B. Down Blvd., Tampa, FL, 33612, USA
| | - Tayler Shreve
- Department of Justice, Law, and Criminology, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA
| | - Kathleen Moore
- Department of Mental Health Law & Policy, University of South Florida, 13301 Bruce B. Down Blvd., Tampa, FL, 33612, USA
| | - Melissa Carlson
- Department of Mental Health Law & Policy, University of South Florida, 13301 Bruce B. Down Blvd., Tampa, FL, 33612, USA
| | - David Braughton
- Agency for Community Treatment Services, Inc., 4612 N 56th St., Tampa, FL, 33610, USA
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Mehta A, Adams N, Fredrickson M, Kraszkiewicz W, Siy J, Hamel L, Hendel-Paterson B. Craving Empathy: Studying the Sustained Impact of Empathy Training on Clinicians. J Patient Exp 2021; 8:23743735211043383. [PMID: 34604510 PMCID: PMC8481707 DOI: 10.1177/23743735211043383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Evidence is sparse when it comes to the longitudinal impact of educational interventions on empathy among clinicians. Additionally, most available research on empathy is on medical trainee cohorts. We set out to study the impact of empathy and communication training on practicing clinicians' self-reported empathy and whether it can be sustained over six months. An immersive curriculum was designed to teach empathy and communication skills, which entailed experiential learning with simulated encounters and didactics on the foundational elements of communication. Self-reported Jefferson Scale of Empathy (JSE) was scored before and at two points (1-4 weeks and 6 months) after the training. Overall, clinicians' mean self-empathy scores increased following the workshop and were sustained at six months. Specifically, the perspective taking domain of the empathy scale, which relates to cognitive empathy, showed the most responsiveness to educational interventions. Our analysis shows that a structured and immersive training curriculum centered on building communication and empathy skills has the potential to positively impact clinician empathy and sustain self-reported empathy scores among practicing clinicians.
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Affiliation(s)
- Ankit Mehta
- HealthPartners, Bloomington, Minnesota, USA
- University of Minnesota, Minneapolis, MN, USA
- Regions Hospital, HealthPartners, St. Paul, MN, USA
| | - Nell Adams
- Regions Hospital, HealthPartners, St. Paul, MN, USA
| | - Mary Fredrickson
- HealthPartners, Bloomington, Minnesota, USA
- University of Minnesota, Minneapolis, MN, USA
- Regions Hospital, HealthPartners, St. Paul, MN, USA
| | - Wojciech Kraszkiewicz
- HealthPartners, Bloomington, Minnesota, USA
- University of Minnesota, Minneapolis, MN, USA
- Regions Hospital, HealthPartners, St. Paul, MN, USA
| | - Jerome Siy
- HealthPartners, Bloomington, Minnesota, USA
- University of Minnesota, Minneapolis, MN, USA
- Regions Hospital, HealthPartners, St. Paul, MN, USA
| | - Lydia Hamel
- Regions Hospital, HealthPartners, St. Paul, MN, USA
| | - Brett Hendel-Paterson
- HealthPartners, Bloomington, Minnesota, USA
- University of Minnesota, Minneapolis, MN, USA
- Regions Hospital, HealthPartners, St. Paul, MN, USA
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Suciu N, Mărginean CO, Meliț LE, Ghiga DV, Cojocaru C, Popa CO. Medical Students' Personalities: A Critical Factor for Doctor-Patient Communication. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179201. [PMID: 34501788 PMCID: PMC8431279 DOI: 10.3390/ijerph18179201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 12/30/2022]
Abstract
The aim of this study was to assess the level of creativity and personality traits and their mutual influence on medical students using the DECAS and BWAS. We performed a prospective descriptive study on 119 medical students from Târgu Mureș, Romania between November 2020 and July 2021, who answered questions relating to the BWAS and DECAS scales to evaluate their creativity and personality traits. Our findings pointed out a reverse correlation between age and both the original and revised BWAS (r = −0.2037, p = 0.0263; r = −0.1931, p = 0.0354). In terms of extraversion, we found a significant positive correlation for both openness (r = 0.3032, p = 0.0008) and emotional stability (r = 0.2868, p = 0.0016) and a negative correlation between extraversion and agreeability (r = −0.2394, p = 0.0087). Regarding creativity, we found positive correlations between emotional stability and both the original and revised BWAS (r = 0.20, p = 0.0279; r = 0.20, p = 0.0245). Medical students’ creativity might be positively influenced by emotional stability and seems to decrease with age. Higher extraversion scores could be related to increased openness and emotional stability as well as decreased agreeability.
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Affiliation(s)
- Nicoleta Suciu
- European and Research Projects Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540136 Târgu Mureș, Romania;
| | - Cristina Oana Mărginean
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540136 Târgu Mureș, Romania;
- Correspondence: ; Tel.: +40-723-278543
| | - Lorena Elena Meliț
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540136 Târgu Mureș, Romania;
| | - Dana Valentina Ghiga
- Department of Medical Scientific Research Methodology, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540136 Târgu Mureș, Romania;
| | - Cristiana Cojocaru
- Doctoral School of “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540136 Târgu Mureș, Romania;
| | - Cosmin O. Popa
- Department of Ethics and Social Sciences, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540136 Târgu Mureș, Romania;
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Aoki Y, Katayama H. Development of the Clinical Interpersonal Reactivity Index to evaluate nurses' empathy. Nurs Health Sci 2021; 23:862-870. [PMID: 34431189 PMCID: PMC9293200 DOI: 10.1111/nhs.12875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 08/02/2021] [Accepted: 08/09/2021] [Indexed: 12/01/2022]
Abstract
We determined the validity and reliability of the Clinical Interpersonal Reactivity Index in a sample of Japanese nurses. Participants were registered nurses at national university hospitals and nursing researchers in Japan. A postal questionnaire was conducted. Construct validity was analyzed by exploratory and confirmatory factor analysis, and convergent validity demonstrated using the Interpersonal Reactivity Index. The Clinical Interpersonal Reactivity Index has an 18-item, two-factor structure with Cronbach's alpha values of 0.87 and 0.73. Confirmatory factor analysis showed a goodness-of-fit index of 0.917, an adjusted goodness-of-fit of 0.894, a root mean square error of approximation of 0.60, and a comparative fit index of 0.911. Correlation analysis between the Clinical Interpersonal Reactivity Index and Interpersonal Reactivity Index indicated the factors were significantly correlated for empathic concern and perspective taking (r = 0.439-0.401). Test-retest assessment showed reliability coefficients for the first factor as r = 0.859 and the second factor as r = 0.709. The Clinical Interpersonal Reactivity Index demonstrated validity and reliability for Japanese nurses. The two factors evaluated perspective taking and unconditional positive regard.
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Affiliation(s)
- Yoshimi Aoki
- Department of Fundamental Nursing, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Harumi Katayama
- Department of Fundamental Nursing, Hamamatsu University School of Medicine, Shizuoka, Japan
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28
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Fukuyasu Y, Kataoka HU, Honda M, Iwase T, Ogawa H, Sato M, Watanabe M, Fujii C, Wada J, DeSantis J, Hojat M, Gonnella JS. The effect of Humanitude care methodology on improving empathy: a six-year longitudinal study of medical students in Japan. BMC MEDICAL EDUCATION 2021; 21:316. [PMID: 34088308 PMCID: PMC8176710 DOI: 10.1186/s12909-021-02773-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 04/29/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Empathy, which involves understanding another person's experiences and concerns, is an important component for developing physicians' overall competence. This longitudinal study was designed to test the hypothesis that medical students' empathy can be enhanced and sustained by Humanitude Care Methodology, which focuses on perception, emotion and speech. METHODS This six-year longitudinal observational study examined 115 students who entered Okayama University Medical School in 2013. The study participants were exposed to two empathy-enhancing programs: (1) a communication skills training program (involving medical interviews) and (2) a Humanitude training program aimed at enhancing their empathy. They completed the Jefferson Scale of Empathy (JSE) seven times: when they entered medical school, before participation in the first program (medical interview), immediately after the first program, before the second program (Humanitude exercise), immediately after the second program, and in the 5th and 6th year (last year) of medical school. A total of 79 students (69% of the cohort) completed all seven test administrations of the JSE. RESULTS The mean JSE scores improved significantly after participation in the medical interview program (p < 0.01) and the Humanitude training program (p = 0.001). However, neither program showed a sustained effect. CONCLUSIONS The Humanitude training program as well as medical interview training program, had significant short-term positive effects for improving empathy among medical students. Additional reinforcements may be necessary for a long-term sustained effect.
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Affiliation(s)
- Yusuke Fukuyasu
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hitomi U Kataoka
- Okayama University Hospital Center for Diversity and Inclusion, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
- Department of Primary Care and Medical Education, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Miwako Honda
- Geriatric Research Division, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Toshihide Iwase
- Department of Primary Care and Medical Education, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroko Ogawa
- Department of Primary Care and Medical Education, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masaru Sato
- Department of Primary Care and Medical Education, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Mayu Watanabe
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Primary Care and Medical Education, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Chikako Fujii
- Okayama University Hospital Center for Diversity and Inclusion, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Jennifer DeSantis
- Department of Psychiatry and Human Behavior, Asano-Gonnella Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Mohammadreza Hojat
- Department of Psychiatry and Human Behavior, Asano-Gonnella Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Joseph S Gonnella
- Department of Psychiatry and Human Behavior, Asano-Gonnella Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
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Zhou YC, Tan SR, Tan CGH, Ng MSP, Lim KH, Tan LHE, Ong YT, Cheong CWS, Chin AMC, Chiam M, Chia EWY, Lim C, Wijaya L, Chowdhury AR, Kwek JW, Fong W, Somasundaram N, Ong EK, Mason S, Krishna LKR. A systematic scoping review of approaches to teaching and assessing empathy in medicine. BMC MEDICAL EDUCATION 2021; 21:292. [PMID: 34020647 PMCID: PMC8140468 DOI: 10.1186/s12909-021-02697-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 04/21/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND Empathy is pivotal to effective clinical care. Yet, the art of nurturing and assessing empathy in medical schools is rarely consistent and poorly studied. To inform future design of programs aimed at nurturing empathy in medical students and doctors, a review is proposed. METHODS This systematic scoping review (SSR) employs a novel approach called the Systematic Evidence Based Approach (SEBA) to enhance the reproducibility and transparency of the process. This 6-stage SSR in SEBA involved three teams of independent researchers who reviewed eight bibliographic and grey literature databases and performed concurrent thematic and content analysis to evaluate the data. RESULTS In total, 24429 abstracts were identified, 1188 reviewed, and 136 included for analysis. Thematic and content analysis revealed five similar themes/categories. These comprised the 1) definition of empathy, 2) approaches to nurturing empathy, 3) methods to assessing empathy, 4) outcome measures, and 5) enablers/barriers to a successful curriculum. CONCLUSIONS Nurturing empathy in medicine occurs in stages, thus underlining the need for it to be integrated into a formal program built around a spiralled curriculum. We forward a framework built upon these stages and focus attention on effective assessments at each stage of the program. Tellingly, there is also a clear need to consider the link between nurturing empathy and one's professional identity formation. This foregrounds the need for more effective tools to assess empathy and to better understand their role in longitudinal and portfolio based learning programs.
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Affiliation(s)
- Yi Cheng Zhou
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
| | - Shien Ru Tan
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
| | - Chester Guan Hao Tan
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
| | - Matthew Song Peng Ng
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
| | - Kia Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
| | - Lorraine Hui En Tan
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
| | - Clarissa Wei Shuen Cheong
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
| | - Annelissa Mien Chew Chin
- Medical Library, National University of Singapore Libraries, National University of Singapore Blk MD6, Centre for Translational Medicine, 14 Medical Dr, #05-01, Singapore, 117599, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
| | - Elisha Wan Ying Chia
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
| | - Crystal Lim
- Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore
- Medical Social Services, Singapore General Hospital, 16 College Road, Block 3 Level 1, Singapore, 169854, Singapore
| | - Limin Wijaya
- Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore
- Department of Infectious Diseases, Singapore General Hospital, 16 College Road, Block 6 Level 7, Singapore, 169854, Singapore
| | - Anupama Roy Chowdhury
- Department of General Medicine, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore
| | - Jin Wei Kwek
- Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore
- Division of Oncologic Imaging, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
| | - Warren Fong
- Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, 16 College Road, Block 6 Level 9, Singapore, 169854, Singapore
| | - Nagavalli Somasundaram
- Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
| | - Eng Koon Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Cr, Singapore, 169610, Singapore.
- Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK.
- Centre of Biomedical Ethics, National University of Singapore, Blk MD 11, 10 Medical Drive, #02-03, Singapore, 117597, Singapore.
- PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
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Continisio GI, Serra N, Guillari A, Lucchese R, Simeone S, Gargiulo G, Toscano S, Capo M, Capuano A, Sarracino F, Esposito MR, Rea T. Evaluation of soft skills among Italian Healthcare Rehabilitators: A cross sectional study. J Public Health Res 2021; 10:2002. [PMID: 34006042 PMCID: PMC8419596 DOI: 10.4081/jphr.2021.2002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 04/24/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Healthcare rehabilitator skills can be grouped into hard and soft skills. Hard skills are specific and teachable, which can be defined and measured, while soft skills are less tangible and more difficult to quantify. The aim of this study is to investigate the level of knowledge of soft skills among Italian healthcare rehabilitators, and how they were acquired. DESIGN AND METHODS Two hundred healthcare rehabilitators, who worked in Southern Italy were enrolled from September 1st to October 31st 2017, and interviewed with Computer-Assisted-Web-Interview (CAWI) software, to assess their level of soft skills. RESULTS Healthcare rehabilitators showed significant satisfaction with university education (59.5%), particularly for theoretical training (64%), while significant dissatisfaction was found for technical-practical training (63.5%), training in patients' family management (66.5%) and stages participation to improve soft skills (59%). Dissatisfied rehabilitators were found for university education of soft skills (59%), particularly for interpersonal relationships with patients family (66.5%) and technical-practical train in(63.5%). Women considered the training courses about soft skills acquisition more useful than men (43.8%). CONCLUSIONS Healthcare rehabilitator training is lacking in the teaching of both technical-practical and soft skills. It is striking that in a healthcare profession like that of the rehabilitator, where practical and empathic skills are fundamental in the relationship with the patients, such skills are not treated in analogously with theoretical training.
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Affiliation(s)
| | - Nicola Serra
- Department of Public Health, University Federico II of Naples.
| | | | - Rosita Lucchese
- Continuing Medical Education Unit, University Hospital Federico II of Naples.
| | - Silvio Simeone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome.
| | | | - Silvia Toscano
- Continuing Medical Education Unit, University Hospital Federico II of Naples.
| | - Marianna Capo
- Department of Humanities, University Federico II of Naples .
| | - Angela Capuano
- Department of Emergency, AORN Santobono-Pausilipon, Naples.
| | | | | | - Teresa Rea
- Department of Public Health, University Federico II of Naples .
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Yoshida T, Watanabe S, Kono T, Taketa H, Shiotsu N, Shirai H, Nakai Y, Torii Y. What impact does postgraduate clinical training have on empathy among Japanese trainee dentists? BMC MEDICAL EDUCATION 2021; 21:53. [PMID: 33446194 PMCID: PMC7807681 DOI: 10.1186/s12909-020-02481-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 12/28/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Enhancing empathy in healthcare education is a critical component in the development of a relationship between healthcare professionals and patients that would ensure better patient care; improved patient satisfaction, adherence to treatment, patients' medication self-efficacy, improved treatment outcomes, and reduced patient anxiety. Unfortunately, however, the decline of empathy among students has been frequently reported. It is especially common when the curriculum transitions to a clinical setting. However, some studies have questioned the significance and frequency of this decline. Thus, the purpose of this study was to determine the impact of postgraduate clinical training on dental trainees' empathy from cognitive, behavioral, and patients' perspective. METHODS This study included 64 trainee dentists at Okayama University Hospital and 13 simulated patients (SPs). The trainee dentists carried out initial medical interviews with SPs twice, at the beginning and the end of their clinical training. The trainees completed the Japanese version of the Jefferson Scale of Empathy for health professionals just before each medical interview. The SPs evaluated the trainees' communication using an assessment questionnaire immediately after the medical interviews. The videotaped dialogue from the medical interviews was analyzed using the Roter Interaction Analysis System. RESULTS No significant difference was found in the self-reported empathy score of trainees at the beginning and the end of the clinical training (107.73 [range, 85-134] vs. 108.34 [range, 69-138]; p = 0.643). Considering the results according to gender, male scored 104.06 (range, 88-118) vs. 101.06 (range, 71-122; p = 0.283) and female 109.17 (range, 85-134) vs. 111.20 (range, 69-138; p = 0.170). Similarly, there was no difference in the SPs' evaluation of trainees' communication (10.73 vs. 10.38, p = 0.434). Communication behavior in the emotional responsiveness category for trainees in the beginning was significantly higher than that at the end (2.47 vs. 1.14, p = 0.000). CONCLUSIONS Overall, a one-year postgraduate dental training program neither reduced nor increased trainee dentists' empathy levels. Providing regular education support in this area may help trainees foster their empathy.
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Affiliation(s)
- Toshiko Yoshida
- Center for Education in Medicine and Health Sciences (Dental Education), Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kita- ku, 700-8558, Okayama, Okayama, Japan.
| | - Sho Watanabe
- Comprehensive Dental Clinic, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, 700-8558, Okayama, Okayama, Japan
| | - Takayuki Kono
- Comprehensive Dental Clinic, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, 700-8558, Okayama, Okayama, Japan
| | - Hiroaki Taketa
- Comprehensive Dental Clinic, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, 700-8558, Okayama, Okayama, Japan
| | - Noriko Shiotsu
- Comprehensive Dental Clinic, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, 700-8558, Okayama, Okayama, Japan
| | - Hajime Shirai
- Comprehensive Dental Clinic, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, 700-8558, Okayama, Okayama, Japan
| | - Yukie Nakai
- Department of Dental Hygiene, University of Shizuoka, Junior College, 2-2-1 Oshika, Suruga- ku, 422-8021, Shizuoka, Shizuoka, Japan
| | - Yasuhiro Torii
- Comprehensive Dental Clinic, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, 700-8558, Okayama, Okayama, Japan
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Blanco JM, Caballero F, Álvarez S, Plans M, Monge D. Searching for the erosion of empathy in medical undergraduate students: a longitudinal study. BMJ Open 2020; 10:e041810. [PMID: 33384394 PMCID: PMC7780525 DOI: 10.1136/bmjopen-2020-041810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/04/2020] [Accepted: 12/08/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To analyse the trajectory of empathy throughout the degree programme of medicine in a Spanish school of medicine. DESIGN Longitudinal, prospective 5-year study, between October 2014 and June 2019. SETTING Students from a Spanish university of medicine. PARTICIPANTS Two voluntary cohorts of undergraduate medical students from two different school years were invited to participate (n=135 (cohort 1, C1) and 106 (cohort 2, C2) per school year). Finally, a total number of 174 students (102 (C1, 71.6% women) and 72 (C2, 70.8% women) students, respectively) were monitored for 5 years. Each cohort was divided in two subcohorts of paired and unpaired students that were analysed to check possible social desirability bias. PRIMARY OUTCOME MEASURE The Jefferson Scale of Empathy (JSE). RESULTS The cohort of 102 students (C1) monitored between their first and fifth years of study (71.6% women) showed an improvement among paired women of 2.15 points in total JSE score (p=0.01) and 2.39 points in cognitive empathy (p=0.01); in the unpaired female cohort the increase was of 2.32 points (cognitive empathy) (p=0.02). The cohort of 72 students (C2) monitored between their second and sixth years of study (70.8% women) displayed a cognitive empathy increase of 2.32 points (p=0.04) in the paired group of women. There were no significant differences between paired and unpaired results for either cohort. Empathy scores among men did not decrease. CONCLUSIONS The empathy of medical students at our school did not decline along grade years. In fact, it improved slightly, particularly cognitive empathy, among women. This paper contributes to enlarge data from Europe, where longitudinal studies are scarce. It supports the idea that there may be global geo-sociocultural differences; however, more studies comparing different school settings are needed.
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Affiliation(s)
- José Manuel Blanco
- School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
- Valle de la Oliva Healthcare Centre, Madrid, Spain
| | | | - Santiago Álvarez
- School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - Diana Monge
- School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
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Baugh RF, Hoogland MA, Baugh AD. The Long-Term Effectiveness of Empathic Interventions in Medical Education: A Systematic Review. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2020; 11:879-890. [PMID: 33244286 PMCID: PMC7685355 DOI: 10.2147/amep.s259718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/17/2020] [Indexed: 06/09/2023]
Abstract
The Association of American Medical Colleges recognizes that empathy is an important part of providing excellent patient care and lists empathy as a Core Entrustable Professional Attribute for physicians. This study is a review of the literature focusing on studies with an educational intervention to promote empathy and at least one year follow-up data. After reviewing the 4910 abstracts retrieved from PubMed, PsycInfo, Cochrane, Web of Science, CINAHL, and Embase; the coauthors selected 61 articles for full-text review and completed a medical education research study quality instrument (MERSQI) to ensure all selected studies scored at least 7 or above. Five studies from the US and seven international studies met our inclusion criteria and formed the basis for the study. Few longitudinal studies with a post-intervention follow-up exist to confirm or disprove the effectiveness and durability of empathy training. Of the published studies that do conduct long-term follow-up, study design and measures used to test empathy are inconsistent. Despite the high degree of heterogeneity, the overwhelming majority demonstrated declining empathy over time. Little evidence was identified to support the ability to augment the empathy of physician trainees in sustained fashion. A model is presented which explains the observed changes. Alternative solutions are proposed, including the selection of more prosocial candidates.
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Affiliation(s)
- Reginald F Baugh
- Admissions, University of Toledo College of Medicine and Life Sciences, Toledo, OH43623, USA
| | - Margaret A Hoogland
- Library, University of Toledo College of Medicine and Life Sciences, Toledo, OH43623, USA
| | - Aaron D Baugh
- Pulmonary, Critical Care, Allergy, Sleep Medicine, University of California San Francisco Medical Center, San Francisco, CA94131, USA
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Brekalo Prso I, Mocny-Pachońska K, Trzcionka A, Pezelj-Ribaric S, Paljevic E, Tanasiewicz M, Persic Bukmir R. Empathy amongst dental students: An institutional cross-sectional survey in Poland and Croatia. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:687-694. [PMID: 33462930 DOI: 10.1111/eje.12557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 04/21/2020] [Accepted: 05/29/2020] [Indexed: 06/12/2023]
Abstract
AIM To determine and compare levels of empathy and its dimensions in Polish and Croatian dental students. METHODS Fourth- and fifth-year dental students (N = 193) at the University of Rijeka and University of Silesia completed questionnaires to determine levels of overall empathy and its dimensions: compassionate care (CC), perspective taking (PT) and ability to stand in someone else's shoes (ASSES). Total empathy and its dimensions were analysed depending on the country of origin, year of study and gender of the participants. The HPS version of the Jefferson Scale of Physician Empathy was used to conduct the research. Statistical analysis was performed using the Mann-Whitney U test. RESULTS The analysis showed no significant differences in total empathy level between Polish and Croatian students (P = .838). However, separate analysis of empathy items showed significant differences between the two groups. Croatian students obtained significantly higher average PT values (P = .021), whilst Polish students had significantly higher CC scores (P < .001). Analysis of Croatian respondents revealed significantly higher ASSES scores in the fourth- and fifth-year students (P = .047). Analysis in the Polish group demonstrated an increase in PT scores from the fourth to the fifth year of study (P = .008). CONCLUSION Croatian students scored higher on items associated with cognitive empathy, whilst Polish students displayed higher values in the aspect of emotional empathy. The present results demonstrated an increase in cognitive empathy level in Polish students, whilst in their Croatian colleagues, the level of cognitive empathy decreased with the progression of the academic programme.
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Affiliation(s)
- Ivana Brekalo Prso
- Department of Endodontics and Restorative Dentistry, Faculty of Dental medicine, University of Rijeka, Rijeka, Croatia
- University of Osijek, Osijek, Croatia
| | - Katarzyna Mocny-Pachońska
- Department of Conservative Dentistry with Endodontics, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Bytom, Poland
| | - Agata Trzcionka
- Department of Conservative Dentistry with Endodontics, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Bytom, Poland
| | - Sonja Pezelj-Ribaric
- University of Osijek, Osijek, Croatia
- Department of Oral Medicine and Periodontology, Faculty of Dental medicine, University of Rijeka, Rijeka, Croatia
| | - Ema Paljevic
- Department of Endodontics and Restorative Dentistry, Faculty of Dental medicine, University of Rijeka, Rijeka, Croatia
| | - Marta Tanasiewicz
- Department of Conservative Dentistry with Endodontics, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Bytom, Poland
| | - Romana Persic Bukmir
- Department of Endodontics and Restorative Dentistry, Faculty of Dental medicine, University of Rijeka, Rijeka, Croatia
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Fernández-Rodríguez LJ, Bardales-Zuta VH, San-Martín M, Delgado Bolton RC, Vivanco L. Empathy Enhancement Based on a Semiotics Training Program: A Longitudinal Study in Peruvian Medical Students. Front Psychol 2020; 11:567663. [PMID: 33192851 PMCID: PMC7658416 DOI: 10.3389/fpsyg.2020.567663] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 10/08/2020] [Indexed: 12/30/2022] Open
Abstract
Background Empathy, as a core element of medical professionalism, is part of leadership in medicine. This attribute, predominantly cognitive, involves understanding and communication capacity. Empathy can be enhanced with courses on medical semiotics. It appears adequate to apply this enhancement in the early stages of professional training. Based on this, this study was performed with the purpose of demonstrating the positive effect that an academic course on medical semiotics has on the development of empathy in medical students. Methods A quasi-experimental study was conducted in one School of Medicine in Peru, where medical students had to attend a 17-week course on medical semiotics as part of their regular training. The sample, composed by 269 students, included two cohorts of third-year medical students. As main measures, the Jefferson Scales of Empathy (JSE), inter-professional collaboration (JSAPNC), and lifelong learning (JeffSPLL), were used. In addition, students’ scores evaluating theoretical and practical aspects of the course were collected once the course was finished. Pre- and post-tests were administered in week 1 and in week 17. Analyses compared measures in both moments and in time. Inter-professional collaboration and lifelong learning scores and empathy scores were used as discriminant and convergent validity measures of students’ course scores, respectively. Results Gender differences on empathy appeared, but only at the beginning. In the entire sample, empathy enhancement was confirmed in time (p < 0.001), with a large effect size (r = 0.45). This effect was also observed in both gender groups, separately. On the contrary, no changes appeared in inter-professional collaboration and in lifelong learning abilities in time. In addition, a positive correlation was observed among empathy, inter-professional collaboration and lifelong learning abilities at the beginning and at the end, confirming that the improvement observed was specific for empathy and explained by the educational intervention assessed. Conclusion These findings bring empiric evidence supporting the positive effect that training in medical semiotics has on empathy. In addition, these findings highlight some gender differences in the development of empathy in medical students.
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Affiliation(s)
| | | | | | - Roberto C Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro, Logroño, Spain.,Platform of Bioethics and Medical Education, Centre for Biomedical Research of La Rioja (CIBIR), Logroño, Spain.,National Centre of Documentation on Bioethics, Rioja Health Foundation, Logro o, Spain
| | - Luis Vivanco
- Platform of Bioethics and Medical Education, Centre for Biomedical Research of La Rioja (CIBIR), Logroño, Spain.,National Centre of Documentation on Bioethics, Rioja Health Foundation, Logro o, Spain
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Souror YR, Aljehani DK, Alshaikh MH. Empathy of dental students towards children after behaviour guidance lectures and clinical experience. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:458-464. [PMID: 32145143 DOI: 10.1111/eje.12523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/10/2020] [Accepted: 03/01/2020] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The empathetic behaviour of dentists is essential for perfect patient care. Because the behaviour of child patients in a dental clinic differs from that exhibited by the adults, knowing of empathy of dental students towards the child in the dental clinic is an important concern. METHODS We distributed a modified form of the Health Professions Student version (HPS-version) of the Jefferson Scale of Empathy (JSE) to dental students in two rounds: (R1) before and (R2) after introducing behaviour guidance subcourse and exposure to 3 clinical experiences with children to measure changes in empathy of dental students towards child patients. The modifications include replacing the "patient" words with "child patients" and translation into Arabic. We checked the internal consistency of the modified form of HPS-version by Cronbach's coefficient alpha test. The significance level was set at 0.05 for all statistical analyses. RESULTS Out of eighty-one, sixty-five dental students completed the survey and attended a behaviour guidance course and three clinical sessions. The questionnaire showed accepted reliability. There was a significant decrease in the empathy of dental students in R2 than R1 (P < .05). The level of empathy for males was less than female students in both rounds (P < .05). CONCLUSIONS The clinical interaction of children by dental students inhibits their empathy towards child patients, and a specific training course is needed to improve dental students' empathy towards children since learning behaviour guidance may not sufficient.
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Affiliation(s)
- Yasser R Souror
- Faculty of Dentistry, Pediatric Dentistry Department, Alazhar University, Assuit, Egypt
- Head of Pediatric Dentistry Department, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Dareen K Aljehani
- Orthodontic Department, Batterjee Medical College, Jeddah, Saudi Arabia
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Ye X, Guo H, Xu Z, Xiao H. Empathy variation of undergraduate medical students after early clinical contact: a cross-sectional study in China. BMJ Open 2020; 10:e035690. [PMID: 32690511 PMCID: PMC7371130 DOI: 10.1136/bmjopen-2019-035690] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Empathy education is very important for medical students. There is little research on the influence of early clinical practice on the development of empathy and other aspects of professionalism in medical students. The aim of this study was to compare the self-reported empathy levels of first-year and second-year undergraduate medical students before and after their early clinical contact curriculum. SETTING The study was conducted at the Shanghai University of Medicine & Health Sciences, Shanghai, China. PARTICIPANTS A total of 257 undergraduate medical students participated in the study. The 154 first-year students were studying in 10 community-based teaching hospitals, and the 103 second-year students were studying in 3 university-affiliated hospitals. PRIMARY AND SECONDARY OUTCOME MEASURES Primary measures: the Jefferson Scale of Empathy-Student version (JSE-S) was compared between students of different sexes and in different academic years before their early clinical contact course. Secondary measures: comparisons were made after they finished the curriculum 3 weeks later. RESULTS A total of 219 of 257 students responded (85.21% response rate), and 214 answers could be analysed (135 first-year and 79 second-year students; 120 female and 94 male individuals). No significant differences in the empathy scores before early clinical contact were observed between students of different sexes and in different academic years. After early clinical contact, the mean JSE-S score of the participants was significantly higher than the mean score at the beginning of the curriculum. CONCLUSIONS Empathy-focused training during early clinical contact can improve the empathetic capacity of undergraduate medical students. Fostering empathetic attitudes among undergraduate medical students is necessary for the early stage of their medical education. Further research is needed on the long-term effects of empathy-focused education in entry-level medical students.
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Affiliation(s)
- Xiong Ye
- School of Clinical Medicine, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Haiying Guo
- Department of Respiratory and Critical Care Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhou Xu
- Education Department, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Xiao
- Department of Respiratory and Critical Care Medicine, Shanghai Jiao Tong University, Shanghai, China
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Chan KD, Humphreys L, Mey A, Holland C, Wu C, Rogers GD. Beyond communication training: The MaRIS model for developing medical students' human capabilities and personal resilience. MEDICAL TEACHER 2020; 42:187-195. [PMID: 31608726 DOI: 10.1080/0142159x.2019.1670340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose: Human capabilities in medicine, including communication skills, are increasingly important within the complex, challenging and dynamic landscape of healthcare. Supporting medical students to manage unavoidable role-related stressors adaptively may help mitigate the anguish that is too commonly reported among the profession. We developed a model, "MaRIS", underpinned by contemplative pedagogy, to support medical students to enhance their human capabilities, across all three domains of Bloom's taxonomy, and their personal resilience. It is the first to integrate Mindfulness, affective Reflection, Impactive experiences and a Supportive environment into medical curriculum design. Here, we describe the theoretical basis underpinning MaRIS and present a preliminary study to evaluate its impact on students' subjectively-rated capabilities.Materials and Methods: A questionnaire capturing self-ratings of competence, empathy and resilience, as well as impressions of their experiences, was administered to foundation year medical students before (T0), during (T1) and after delivery (T2).Results: Fifty-five students completed the survey at all time points. Mean scores for all domains increased significantly from T0 to T1 and from T0 to T2. Free-text comments suggest learning impact across the cognitive, psychomotor and affective domains.Conclusions: MaRIS appears to facilitate medical students' establishment of the foundations for building the human capabilities and personal resilience required for professional practice.
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Affiliation(s)
- Kwong D Chan
- Griffith Health Institute for the Development of Education And Scholarship (Health IDEAS), Griffith University, Gold Coast, Australia
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Linda Humphreys
- Griffith Health Institute for the Development of Education And Scholarship (Health IDEAS), Griffith University, Gold Coast, Australia
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Amary Mey
- Griffith Health Institute for the Development of Education And Scholarship (Health IDEAS), Griffith University, Gold Coast, Australia
| | - Carissa Holland
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Cathy Wu
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Gary D Rogers
- Griffith Health Institute for the Development of Education And Scholarship (Health IDEAS), Griffith University, Gold Coast, Australia
- School of Medicine, Griffith University, Gold Coast, Australia
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Palombaro KM, Black JD, Dole RL, Jones SA, Stewart AR. Civic-Mindedness Sustains Empathy in a Cohort of Physical Therapy Students: A Pilot Cohort Study. J Patient Exp 2019; 7:185-192. [PMID: 32851139 PMCID: PMC7427372 DOI: 10.1177/2374373519837246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Empathy is critical to patient-centered care and thus is a valued trait in graduate health-care students. The relationship between empathy and civic-mindedness in health professions has not previously been explored. Objectives: (a) To determine whether significant differences occurred on the Jefferson Scale for Empathy–Health Professions Student Version (JSE-HPS) and Civic-Minded Professional scale (CMP) and its subscales across the curriculum, (b) to explore a potential relationship between civic-mindedness and empathy in a cohort of graduate physical therapy (PT) students at regular intervals, and (c) to explore the predictive ability of civic-mindedness on empathy scores. Methods: This study was a convenience sample of a cohort of 48 PT students who completed both the JSE-HPS and the CMP at 4 points of a service-learning intensive curriculum. Statistical analysis included descriptive statistics, a Friedman’s analysis of variance with Wilcoxon signed-ranks post hoc testing, and Spearman correlations with stepwise linear regressions. Results: Statistically significant differences were not found for the JSE-HPS. Civic-Minded Professional scores increased across the curriculum. The JSE-HPS, the CMP, and various CMP subscales were significantly correlated. The JSE-HPS pretest scores were predictive of the year 1 and 2 posttest JSE-HPS scores. Conclusion: This study’s findings indicate that service-learning and the resulting development of civic-mindedness supports empathy. Programs could use JSE-HPS pretests to identify individual graduate students need for empathy mentorship upon program entrance or as one admission criterion.
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Affiliation(s)
- Kerstin M Palombaro
- Institute for Physical Therapy Education, Widener University, One University Place, Chester, PA, USA
| | - Jill D Black
- Institute for Physical Therapy Education, Widener University, One University Place, Chester, PA, USA
| | - Robin L Dole
- School of Human Service Professions, Widener University, Chester, PA, USA
| | - Sidney A Jones
- Institute for Physical Therapy Education, Widener University, One University Place, Chester, PA, USA
| | - Alexander R Stewart
- Institute for Physical Therapy Education, Widener University, One University Place, Chester, PA, USA
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